Professional Documents
Culture Documents
PHILHEALTH CIRCULAR
No. 13, series of 2007
Pursuant to PhilHealth Board Resolution No. 992 s. 2007 and in order to continuously
provide access to outpatient services to Overseas Workers Program (OWP) members and
dependents, PhilHealth shall implement an Enhanced Outpatient Benefit (OPB) Package.
1. The OPB for OWP shall be administered and managed by the Department of Health
(DOH) National Center for Health Facility Development NCHFD);
2. The benefits provided in the package may be availed in identified participating DOH
hospitals (See Annex A for the list of participating DOH Hospitals).
3. This package is separate from the existing PhilHealth benefit such as: TB DOTS,
Maternity Package, Outpatient Day Surgeries & Procedures, Dialysis, and In-patient Care.
4. The following are the services included in the Enhanced OWP OPB Package to be
provided by participating DOH hospitals at no additional cost to the patient/members
(zero co-pay):
4.1 Consultation
4.2 Diagnostic Services
5. PhilHealth shall use the global budget scheme in the payment for the delivery of Enhanced
OWP OPB services. The amount of Php 6M for 2007 shall be allocated as global budget
for this package and adopt zero co-pay system (no out of pocket payment) in the
availment of the package. Succeeding allocations shall be subject to the approval of the
PhilHealth Board.
The amount shall be released to the DOH National Center for Health Facility
Development (NCHFD), which shall allocate the same to participating DOH hospitals.
The DOH NCHFCD shall develop guidelines in the disposition of the Global Budget
subject to the usual accounting and auditing rules and regulations. The savings from said
amount shall accrue to the benefit of the accredited/authorized health care providers.
However, in case of insufficiencies, the particular services due to the concerned
beneficiaries shall be delivered at the cost of the accredited health facility.
6. All eligible OWP members and their dependents may avail of this Package. The availment
of this package shall not be deducted from the 45-day benefit limit of members and
dependents.
7. Availment Mechanism
7.1 To avail of the Enhanced OWP OPB Package the member/dependent must present the
following to the receiving clerk of the hospital:
Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION
Citystate Centre, 709 Shaw Boulevard, Pasig City
Healthline 637-9999 www.philhealth.gov.ph
7.2 The hospital shall verify the validity of the document(s) presented and check if the patient
is listed as dependent of the member;
7.3 Availee shall proceed to the doctor for consultation;
7.4 The hospital shall document the availment using the PhilHealth-prescribed form(s) (Annex
C)
8. To provide the Corporation with basis for evaluating the program and serve as inputs in
making policy decisions, the participating DOH hospitals shall submit quarterly reports on
the availment of this package and financial report on the utilization of the budget to the
Health Informatics of the Quality Assurance Research and Policy Development Group on
or before the 10th day of the first month of the succeeding calendar quarter following the
date of the initial implementation of this package.
10. All DOH hospitals currently accredited by PhilHealth that shall participate in the delivery
of this benefit package shall not be required a separate accreditation.
11. A Memorandum of Agreement shall be forged between the DOH and PHIC for the
implementation of this Circular.
12. All other issuances inconsistent with this Circular are hereby repealed, amended or
modified accordingly.
San Lazaro Hospital Tertiary Care Quirricada St. Sta. Cruz, Manila
Dr. Jose Fabella Memorial Tertiary Care Lope de Vega, Sta. Cruz, Manila
Hospital
1
Annex A
St. Anthony Mother and Secondary Basak, San Nicolas, Cebu City
Child Hospital Care
2
Annex A
3
Annex B
A. ACUTE GASTROENTERITIS
1. For dehydration:
Oral Rehydration Solution
2. Zinc at a dose of 10-20 mg/day may be given for 10-14 days to all children with diarrhea.
3. For malnourished children or children who develop diarrhea during or shortly after measles, give oral vitamin
A at the following doses:
< 6 mos 6-12 mos 12 mos – 5 yrs
First day 200,000 units/dose 200,000 units/dose 200,000 units/dose
Second day 50, 000 units 100,000 units 200,000 units/dose
1. Empiric treatment regimens for uncomplicated acute pyelonephritis (adapted from PSMID guideline, 2004,
Grade A)
Oral antibiotics Dose, Frequency
Ofloxacin 400 mg BID
Ciprofloxacin 500 mg BID
Gatifloxacin 400 mg OD
Cefixime 400 mg OD
Cefuroxime 500 mg BID
Co-amoxiclav 625 mg TID
Annex B
2. Antibiotics that may be used as empiric therapy for complicated UTI (adapted from PSMID guideline, 2004,
Grade B)
Oral antibiotics Dose, Frequency Duration
Ciprofloxacin 250-500 mg BID 14 days
Norfloxacin 400 mg BID 14 days
Ofloxacin 200 mg BID 14 days
1. The primary treatment for acute bacterial rhinosinusitis is antibiotics. [Philippine Society of Otolaryngology –
Head and Neck Surgery (PSO-HNS), 2006, Grade A]
Recommended Antimicrobial for Adults with Acute Bacterial Rhinosinusitis (PSO-HNS 2006)
First-line antimicrobials Amoxicillin
2. Paracetamol or Ibuprofen is effective in treatment (in the first 48 hours) of fever associated with sore throat
(PSO-HNS 2006, Grade A)
3. Penicillin is the drug of choice for the treatment of streptococcal pharyngitis. The antibiotic has proven
efficacy and safety, a narrow spectrum of activity and low cost (PSO-HNS 2006, Grade A).
4. Erythromycin (Pediatric dose: 30-50 mg/kg/day in 4 divided doses, Adult dose: 1-2 g/day in 4 divided doses)
is a suitable alternative for patients allergic to penicillin who manifest hypersensitivity to beta lactam antibiotics
(PSO-HNS 2006, Grade C).